Stemmler Hans-Joachim¹, Lässig Dorit¹, Stieber Petra², Bauerfeind Ingo³, Kahlert Steffen³, Fasching Peter Alexander⁴, Beckmann Matthias Wilhelm⁴, Glattes Margrit⁵, Goldmann-Posch Ursula⁶, Hoffmann Verena,¹ Untch Michael⁷ and Heinemann Volker¹

¹Department of Hematology and Oncology. ²Department of clinical Chemistry. ³Department of Gynaecology and Obstetrics. 1–3Ludwig-Maximilians University of Munich, Klinikum Großhadern, Munich, Germany. ⁴Department of Gynaecology and Obstetrics, University of Erlangen, Germany. ⁵AOK Rheinland/Hamburg, Germany. ⁶Mamazone e.V., Augsburg, Germany. ⁷Department of Gynaecology and Obstetrics, Helios Klinikum, Berlin-Buch, Germany.

Abstract

Background: International guidelines for the surveillance of breast cancer patients recommend a minimized clinical follow-up including routine history and physical examination and regularly scheduled mammograms. However, the abandonment of scheduled follow-up examinations in breast cancer survivors remains a contradiction to established follow-up guidelines for other solid tumours.

Patients and Methods: We report the patients’ view on the basis of a survey performed in two separate geographical areas in Germany. The questionnaires were sent out to 2.658 patients with a history of breast cancer.

Results: A total of 801 patients (30.1%) responded to the questionnaire. The results of the survey can be summarized in two major categories: First, necessity for surveillance was affi rmed by a majority (>95%), and 47.8% of the organized patients answered that there was a need for more intensive diagnostic effort during follow-up. The main expectation from an intensified follow-up was the increased feeling of security as expressed by >80% of the women. Second, the present survey indicates that most of the regularly scheduled follow-up visits were expanded using extensive laboratory and imaging procedures exceeding the quantity of examinations recommended in the present follow-up guidelines.

Conclusion: Despite the fact that only one third of the patients responded to the questionnaire, the survey indicates that a majority of physicians who treated these patients still do not accept the present follow-up guidelines. To some extent this may be explained by the observation that patients and possibly also their doctors trust that intensified follow-up increases diagnostic security and survival. Since considerable changes in the treatment options of breast cancer have been made during the last decades a new trial of investigations in follow-up is warranted.

Discussion
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